Antiseptics are antimicrobial chemical substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis or putrefaction caused by microorganisms, and disinfectants destroy microorganisms found on nonliving objects.
In the second half of the nineteenth century, inspired by Louis Pasteur's germ theory of disease, the doctors Lister, Semmelweis, Tichenor and others introduced antiseptic treatment and surgical methods into their daily work and initiated a completely new quality of medicine: open wounds, surgery, and infectious diseases no longer led to painful death but were cured through topical antiseptics, and later by internal antibiotics.
Many powerful and fast acting antiseptics have been developed by chemists and applied by doctors and households; some have been abandoned because they produced side effects, others because they were just too inexpensive and not sufficiently profitable to the medical industry; a handful, mainly alcohol based antiseptics, became standards.
From the beginning Pasteur and his followers stipulated that disinfection and antiseptic methods are not 100% effective procedures and have to be verified and classified using the “killing rate” on the specific microorganisms reached and attacked by the disinfecting agent. Today we apply “fast acting” and “persistent” topical antiseptics that all should be “broad spectrum”, i.e. effective against a variety of microorganisms. Fast acting antiseptics are measured by significant reduction in strength determined by cultures obtained a few moments (less than minutes) following application of the antiseptic.
The quality of “persistence” refers to the ability of the antiseptic to continue to kill once it is applied and is due to the retention or binding of the chemical in the stratum corneum of the skin after partial evaporation and after rinsing. It is measured by the time for the micro-flora to be restored to the baseline which existed before the application.
Currently there are several fast acting antiseptics, effective within 20 seconds against transient microorganisms which could cause infections. Most of these antiseptics are based on alcohols, iodine solutions, or chlorides. However all these fast acting antiseptics cannot prevent fast repopulation of the depleted (mainly evaporated) “killing ground” where also all the natural body protection (fatty acids, different salts, regulated pH 5.4-5.5) against invasions has been destroyed.
Persistence, as applied in food industry or exhibited in ancient embalming practices, has remained an elusive goal of medical antiseptic technology. Regulating bodies like the FDA have required persistence since the 1970s for any new antiseptic to be approved, with very little response, actually enhancing the utilization of outdated, nonpersistent, alcohol based disinfectants. Additional regulations for new antiseptics to be tested and evaluated as “medications”, in lengthy and costly clinical trials, led to an end to all small enterprise chemical development and production of innovative disinfectants.
Nature has produced the bill: The surviving microorganisms evolved to develop resistance to short acting threats that allow them to immediately recolonize the tissue cleansed by the short persistence antimicrobials with the next transient flora from the next patient or from the next hand grip.
Best practice now requires doctors and care personnel to wash their hands with antiseptics before and after each patient, X times a day! The campaign “Clean Hands” in German hospitals mounted dispenser bottles for disinfectants on each patient's bed, because the walk to the room's door and back would add up to miles and hours every day. But the doctors and caregivers just cannot do it X times a day without heavy damage to their skin and their health. Compliance therefore remains low and the microorganisms are “taking over”: In Germany every year some 800,000 patients (1 out of 20!) fall seriously ill by in-hospital infections; the number of fatal casualties are kept secret by the hospital companies.